Smile Hair Clinic - Istanbul

Thank you for sharing your history.

Based on what you've described — progressive thinning since age 18 and a general decrease in hair density — it does sound somewhat consistent with diffuse androgenetic alopecia (a subtype of male pattern baldness). However, after reviewing your photos, we noticed that the most significant thinning seems to be localized at the crown (vertex) and behind the ears. This isn’t a typical pattern for classic diffuse androgenetic alopecia, where thinning tends to be more uniform across the top of the scalp.

Because of this unusual distribution, we highly recommend that you also consider a detailed medical workup to rule out additional or secondary causes of hair loss, such as:

1. Nutritional deficiencies (iron, zinc, vitamin D, B12)

2.Thyroid function abnormalities

3.Chronic stress or past illness (telogen effluvium)

4.Scalp inflammation or dermatological conditions

5.Autoimmune factors

In other words, before starting any treatment or medication, it’s essential to identify the exact cause of your hair loss. Otherwise, therapy may be ineffective or even inappropriate.

As for treatment - topical form of Minoxidil and finasteride remain first-line therapies for androgenetic alopecia and could still be beneficial in your case — especially if there is any hormonal component involved.

1. Minoxidil can improve blood circulation and stimulate regrowth.

2. Finasteride reduces DHT levels, which helps prevent further miniaturization of hair follicles.

That said, if medications and supportive therapies prove ineffective and the hair loss continues to progress, then surgical options such as a hair transplant should only be considered a few years after the active shedding phase has ended. Performing a transplant while the hair loss is still unstable could lead to poor long-term outcomes, so timing and proper stabilization are crucial.

What you’ve described — a naturally high or M-shaped hairline without signs of active hair loss — is actually more common than it may seem, and we do receive requests for cosmetic hairline refinement from patients like you. These procedures are typically performed for aesthetic reasons, not due to balding, and can be highly successful when planned conservatively and with long-term naturalness in mind.

We’ve had a chance to review your photos, and one of the key observations — particularly regarding the muscle structure of your forehead — is that the temple corners lack underlying frontalis muscle. This is actually a positive sign, as it means those areas can often be safely filled in with transplanted grafts without risking unnatural movement or future complications.

Your naturally thick hair is a great advantage in designing a refined, natural-looking hairline. Also, since your hairline has remained unchanged since your late teens and there are no signs of progression, the use of finasteride or minoxidil is not necessary in your case — especially considering your past side effects. You may still be a very good candidate for hair transplantation with proper planning and realistic expectations.

Based on the photos you’ve shared, we estimate that approximately 1500–1700 grafts would be needed to achieve your desired hairline design. Your donor area looks more than suitable for this number of grafts, and since there is no ongoing hair loss, it's very likely that you won’t need a second procedure in the future.

Since your mustache hair loss occurred due to an accident and it has already been over a year, you are very likely a suitable candidate for a facial hair transplant — even at the age of 19. Traumatic hair loss (like from burns, cuts, or deep wounds) is quite different from genetic or hormonal causes, and if the skin in that area has fully healed and there is no active inflammation or scarring that prevents graft survival, a transplant can be performed safely.

Based on your description, it sounds like you're experiencing gradual hairline recession, which is common, especially with a family history of male pattern baldness. Since your hair is thick in the back and on the sides, you seem to have a good donor area, which is essential for a hair transplant.

Considering you don’t have much hair loss elsewhere and the recession is relatively stable, you're likely a good candidate for a hairline restoration. However, we'd need to assess the situation further with a proper consultation, as we would want to ensure your donor area has enough density to achieve a natural result.

Since your hairline has been gradually receding, you might want to consider starting with non-surgical treatments like finasteride or minoxidil to stabilize your hairline before proceeding with a transplant, or to combine them with the transplant for enhanced results.

First of all, I’m really sorry you’re going through this. IPL (intense pulsed light) isn’t meant for the hairline, and it sounds like you’ve been incredibly patient trying to recover what was lost.
Now to the point:

Yes, hair transplantation in such an area is quite possible, even if there is ‘live but weak’ hair left there. The main thing is to assess whether this hair will actually recover or whether it has already been permanently miniaturised. In practice, if nearly a year has passed and the hair is still thin, light and ‘fluffy’, then most likely it will not return to its previous appearance. And discontinuing minoxidil will cause these fluffy hairs to regress.

The good news is that such areas can be covered with a transplant, especially if they spoil the symmetry or stand out visually. Thin vellus hair will not interfere with the engraftment of new grafts; on the contrary, it is often simply ‘rubbed out’ by the new volume.

So if you have been treating for a year and there are no results, it may be time to consider transplantation as a real option. If you want, you can evaluate the photos and understand how realistic it is to fix this and how many grafts may be needed. You are definitely not alone, and such cases can be resolved.